Assessment of the need for a training course in rational use of drugs: a cross-sectional pilot study.

Rational use of drugs means need-based use of them keeping in mind the pathological status, therapeutic indices, drugs interactions and adverse drug reactions. Lacunae in the existing undergraduate curriculum cause irrational use of drugs. The present study was undertaken among 2,200 fresh medical graduates from all over the country with a list of questionnaire distributed among them and analysing the answers. The aim was to ascertain the adequacy of present undergraduate curriculum on pharmacology in equipping the doctors on rational use of drugs and to assess the need and feasibility of Refresher's course. More than half (55%) replied prescriptions were not truly rational. Ninety-eight per cent opened Refresher's course is beneficial in rational prescribing. This cross-sectional survey could provide a glimpse of existing undergraduate pharmacology curriculum and its impact on rational prescribing practice. The Refresher's course in the early internship period involving the clinical departments and department of pharmacology is suggested.

Surrogate endpoints: do they really contribute in therapeutic decision making?

Surrogate endpoints are substitutes for the true endpoints and measured in any clinical research to relate in some way to the outcome of primary interest. Inappropriate selection of surrogate markers may lead to controversies during clinical trials or therapeutic interventions. Use of surrogate markers depends upon thorough understanding of the pathophysiology of the disease and pharmacology of drugs. Results obtained with surrogates should be regarded as preliminary and necessitates definitive studies.

Role of Anopheles culicifacies during an outbreak of malaria in Gorubandha P.H.C., Assam.

Entomological investigation during an outbreak of malaria in Gorubandha PHC in Sonitpur district revealed unusually high density of Anopheles culicifacies followed by An.minimus. Parity rates of both the species were very high, 65% and 62.2% respectively. An. culicifacies was incriminated as malaria vector. Sporozoite rate recorded was 0.63%. Both the species were found susceptible to DDT. This substantiates the epidemiological observation which yielded 98% Plasmodium falciparum malaria out of 35.2% malaria positive cases. Incrimination of An. culicifacies means adding one more malaria vector to this region.

An ELISA method for quantitation of tubulin using poly-1-lysine coated microtiter plates.

A new, sensitive and convenient ELISA method has been developed for quantitation of tubulin using poly-1-lysine (PLL) coated multiwell microtiter plates. Binding of tubulin to untreated plastic surface of microtiter plates was extremely poor. Coating of wells with PLL enhanced the binding and facilitated quantitation by ELISA. Binding of tubulin was followed by stepwise additions of rabbit anti-tubulin IgG, HRP-conjugated goat anti-rabbit IgG and colour reagent. The method has been successfully applied to quantitate the tubulin content of extracts from rat brain and liver as evident from the excellent correlation of the results with those obtained from 3H-colchicine binding assay. The detection limit is as low as 5 ng, which is relatively better than that of the previous RIA methods. The ELISA method does not involve the use of any radioactive compound and all reagents required for this assay are commercially available.

Falciparum malaria.

We analysed cases of hematologically proved cases of Plasmodium falciparum malaria encountered from July 1984 to Dec 1985 in a military hospital. The age range was 3 days to 10 years. Majority presented with classical symptom of fever (92.7%). Others presented with gastrointestinal (7.3%), hepatic (4.5%), central nervous system (7.3%) and respiratory (3.6%) symptoms. Anemia was found in 36.4%. Hepatosplenomegaly was present in majority of the cases. The rare findings were polyarthritis, rash, urticaria and cerebellar features. All cases responded to chloroquine or quinine. No resistance to drugs was found and there was no mortality.